Do SSRIs and SNRIs Cause Addiction or Dependence?

There are many people today receiving SSRIs or SNRIs for medical conditions that cover a wide range of conditions, syndromes, illnesses, and diseases. Note I highlighted a word: condition. Some of the conditions doctors prescribe SSRIs are not illnesses, syndromes, or diseases but are simply “conditions.” For example, a temporary depression after a loved one dies or one loses a leg can cause what is called “situational depression” which means the person knows precisely why the depression occurred and it is a condition but is not associated with any illness. In cases like this, in the olden times, SSRIs were not prescribed, only mild antidepressants for temporary use.

Then the SSRI and SNRI fashion hit and all turned up side down for the patients and down side up for the pharmaceuticals and for doctors who accept money and/or gifts from pharmaceuticals for prescribing drugs they recommend.

Do doctors really understand what dependence on a drug really means? A friend just recently tried to stop taking an SSRI and contacted me because she was getting these huge “brain zapping” side effects as a result of stopping the SSRI. She did not just stop the medicine but followed the reduction instructions of the doctor. The doctor told my friend that SSRIs are not addictive but when she had a hard time stopping them she suggested “oh just tough it out.” So let me ask this question: if a drug is not addictive what is there to “tough out”?

So let’s discuss the dependence versus addiction and see which is worse and why.

As per the Merriam online dictionary, the definition of addiction is as follows:

Addiction is a persistent, compulsive dependence on a behavior or substance. The term has been partiallyreplaced by the word dependence for substance abuse. Addiction has been extended, however, to include mood-altering behaviors or activities…

For dependence the same dictionary suggests the following definition:

State of relying on or requiring the aid of something; a state in which there is a compulsive chronic need, as for a drug; a compulsive use of a substance despite significant problems resulting from such use. Although tolerance and withdrawal were previously defined as necessary and sufficient for dependence, they are currently only two of several possible criteria…

Thus the distinction between “dependence” and “addiction” is quite a thin line and the only thing seems to distinguish the two is that addiction suggests a compulsive behavior of seeking out more whereas in dependence it is simply not being able to function without. Is there any difference you may ask?

In fact there is a a difference at the molecular level.

In addiction the receptors of the brain that normally take up the substance naturally as the brain manufactures them in the form of neurotransmitters burn up if the substance is provided too often. Some of these receptors, such as D2 for dopamine that is related to alcoholism and street drug use, are not reversible damages and so the brain needs more drugs to receive the same comfort. This is addiction.

In dependence something else goes wrong in the brain that may not be permanent but is equally paralyzing however temporary–it may take years for this temporary problem to resolve. Take SSRIs for example. I showed in the previously linked to article above how SSRIs plug the neuron’s “sensing organ” that normally “reuptakes” neurotransmitters and tell the cell to finish making then; there is enough. SSRI inhibit the function of these reuptake sensors by plugging them up so when the neuron had made enough neurotransmitter, it has no idea! It just keeps on making more.

Now if we stop the SSRI on the spot, our brain has no idea what to do. Suddenly the plug is out and it senses that enough neurotransmitter was made so it stops but it does not know how to stop and how to restart again with the rhythm it had before the SSRI was introduced, so it stops and goes random. This creates a brain environment that is on and off. It comes with zapping (too much activity) in one moment and then complete brain freeze (stops making) the next. This can go on for quite some time before the brain recovers. This is called dependence but in street parlance “flashback.”

When SSRIs and SNRIs came into fashion, this dependence was neither envisioned nor taught to medical students in school. Lucky to most doctors, they do not take SSRIs or SNRIs and so they have no idea what they put their patients through when they just tell the patient “oh just tough it out!”

This is not a question of being tough or be able to tough it out. The process damages the brain!

For heaven’s sake doctors! Wake up please and either stop prescribing drugs you are not familiar with or take them yourself first and then stop to see how it feels so you can relate! You are an embarrassment to the American medical institution for not knowing what you prescribe!! Stop please! You swore and oath of Do No Harm and you are harming every single person to whom you prescribe SSRI and SNRI without any reason!

Comments are welcome as always!

Angela

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About Angela A Stanton, Ph.D.

Angela A Stanton, PhD, is a Neuroeconomist focusing on chronic pain--migraine in particular--, electrolyte homeostasis, nutrition, and genetics. She lives in Southern California. Her current research is focused on migraine cause, prevention and treatment without the use of medicines. As a forever migraineur from childhood, her discovery was helped by experimenting on herself. She found the cause of migraine to be at the ionic level, associated with disruption of the electrolyte homeostasis, resulting from genetic variations of all voltage gated channels that modulate electrolytes and voltage in the brain, insulin and glucose transporters, and several other related variants, such as the MTHFR variants of the B vitamin methylation process and many others. Migraineurs are glucose sensitive and should avoid eating carbs as much as possible.
She is working on the hypothesis that migraine is a metabolic disease.
As a result of the success of the first edition of her book and her research and findings after treating over 4000 migraineurs successfully world wide, all ages and both genders, she published the 2nd (extended) edition of her migraine book "Fighting The Migraine Epidemic: Complete Guide: How To Treat & Prevent Migraines Without Medications". The 2nd edition is the “holy grail” of migraine cause, development, treatment and prevention, incorporating all there is to know. It includes a long section with for medical and research professionals. The book is full of academic citations (over 800) to authenticate the statements she makes to be followed up by those interested and to spark further research interest. It is a "Complete Guide", published on September 29, 2017.
Dr. Stanton received her BSc at UCLA in Mathematics, MBA at UCR, MS in Management Science and Engineering at Stanford University, PhD in NeuroEconomics at Claremont Graduate University, and fMRI certification at Harvard University Medical School at the Martinos Center for Neuroimaging for experimenting with neurotransmitters on human volunteers, and is currently studying Functional Medicine. Dr. Stanton is an avid sports fan, currently enamored by resistance training and weight lifting, which she does three times a week with a private trainer. For relaxation (yeah.. about a half minute each day) Dr. Stanton paints and photographs. Follow her on Twitter at: @MigraineBook